Many years ago, I decided to lose some weight. I was able to lose about 25 pounds and have kept off 20 of those pounds for many years. That’s better than about 95% of people who try to lose weight. Recently, I was able to lose those five pounds again in just two days. How did I do it? Accidentally–with a violent case of food poisoning and lots of vomiting. I was going to post before/after pictures without a blue shirt on, but Cheryl said it wasn’t a good idea. Considering the way that I lost it, by the time you read this I expect I will have gained those five pounds back. Maintaining results does not only depend on whether you achieved the results. How you achieve the results matters a lot, too.
Good behavior analysts know that you have to measure both behavior changes and the results of those behaviors changes. For example, if you want to lose weight you should measure the behavior changes that you want to make (e.g., eat salad, exercise, avoid late-night snacks) and the results (e.g., what the scale says). Likewise, if you want to help a child with autism refrain from severe problem behavior, we have to look at both behavior changes (e.g., how many self-injurious behaviors per day), but also the results of those behaviors (e.g., Does the person have the opportunity to participate in community settings? Do staff or parents have to constantly avoid situations that may make the child upset?). There is a lot of great advice for BCBA’s on this topic. See this book for an excellent discussion.
Although this is well understood in the literature, I believe that often it is implemented very poorly in practice. Why? There is great advice for managing the conflicts between measuring results and measuring behavior changes. But I find the advice on selecting which results to target less satisfying. Yes, the ACORN test is good, just not sufficient to help most of us find the mission of our jobs.
A lot of this blog is dedicated to situations where BCBAs get this wrong in practice. Common examples include attempts to improve training by teaching staff to accept feedback appropriately or improve performance with public posting of data. But if you look for it you will see this problem everywhere. Anyone in management should take care to make sure you don’t have results measures or behavior change measures in place that are creating havoc on the things you truly value.